I was standing in the immigration line at Jinnah International Airport in Karachi, clutching my passport with a valid visa and my negative COVID test result in one hand, and my carry on bag in the other.

The last time I was standing in the same line, I was heading back to the US to an empty home, with promise of more darkness and despair. The feeling of betrayal had weighed heavily on me and I couldn't see a future for myself where I would be over my ex-fiancée, or where I would ever be willing to open up my heart again. If it hadn't been for my PhD degree that I needed to finish after already slaving away on it for 5 years, I may just have stayed in Pakistan and never gone back to the US.

But what a tragedy that would have been. For I would not have met her. The woman, my wife, who was waiting for me now, on the other side of the world. Whose light had shown me the way even in my darkest times. She had saved me from myself, and I could never forget that. I could only hope that I had it in me to be the man that she deserved.

"What was your purpose of visit to Pakistan?", the immigration officer asked me, as I handed him my Pakistani passport with with a J-1 visa. A non-immigrant visa issued to research scholars, and exchange visitors participating in programs that promote technical and cultural exchange, and is especially popular among those obtaining medical or business training within the U.S.

"I was visiting family...my father wasn't feeling well", I replied nonchalantly. And somehow ended up getting married to the most incredible woman in the world!

I must have been grinning very obviously at the thought that had crossed my mind, because despite my mask the immigration officer asked me, "Abu ki tabiyat kharaab thi tou muskaraa kyun rahein hai? (If your father wasn't well, why are you smiling?)

Oh Geez...

"Umm...woh sahi ho gayein hain ab (he is fine now)"

The guy raised an eyebrow at me, but stamped my passport anyway and let me go.

Whew! These Pakistani immigration officials are sometimes stricter than the ones on the US side...

Twenty minutes later I was standing in the mithai (traditional sweets) shop. I had meant to get some mithai yesterday but between taking Ami to the shopping mall and trying to pack all the clothes and jewellery she had bought for Madi, I just didn't get the time. But my wife loved mithai...so I was going to get some for her, even if it was the relatively stale airport kind.

But what shall I get?

I decided to text her and ask, 'At the mithai shop in airport. What sweet stuff do you want from here?'

She replied almost immediately.

'Only you 💖'

I chuckled thinking of how she must have smiled while biting her lower lip and typing that message.

'Stop flirting with me Madiha A. Omar and answer my question!'

It didn't take her long to reply, 'I won't stop flirting! I can do whatever I want with you now 😏'

Man...she is fiesty today! My sweet, innocent wife may not be as inhibited as I thought she would be

"Bhai saab, kuch lein ge bhi ya idhar kharai ho ke sirf haste rahein ge? (Sir, are you going to buy something or just stand here laughing?)", the mithai shop man asked me with an amused look in his eyes.

That snapped me out of my untimely, even if appropriate thoughts of me with my wife.

I quickly bought the mithai that I knew she liked; gulab jaman, habshi halwa and barfi, and I got some extra for my in-laws. Then, I got the hell out of that mithai shop, before the shopkeeper could give me anymore weird looks.

When I looked at my phone again she had sent another message, 'Sorry about that last text 😳'

And...my shy Madi is back!

'Madi you never have to be embarrassed in front of me. And yes, I am yours to do whatever you want 🤭'

Two minutes later she texted again, '🙈🙈🙈'

Ugh...why hasn't teleportation been invented yet?? I want to be with her right now!

I took a seat in front of the departure gate and looked up to make sure no one was looking at me now and then let my face break out into a huge grin as I scrolled through all the pictures that Sehr had sent to me of Madi from our Nikah day.

I can't wait to be with her

T minus 8 hours

'Sitting in the travel lounge literally counting minutes now'

I looked at the text message Omar had sent sometime last night while I was asleep.

Me too, Omar...me too

Ok...focus Madi. You still have to get through rounds this morning

I had wanted to take the day off. My last day of being a resident was going to be in 3 days from now. But with many of the senior residents moving out of Chicago after our graduation and the COVID units still being full I just could not find someone to cover me for 3 days in a row. Because I would rather take off 2 days after my husband came home, I had decided to work this morning and take an early leave so I could pick him up from the airport at 4 pm. I had then planned to drop him off at his apartment, before going back to my parents' house to get ready for the evening reception and rukhsati they had planned at an open air event space in the suburbs.

In true desi style, my parents guest list had started off at 20 people, but ended up with thrice that amount. If it hadn't been for the open air space we were able to get in one of the botanical gardens, I would have refused to participate in that event...from a COVID standpoint that is. But given the space, we, as in my 'girl squad' with help from the men in their lives, were able to set up tables in a way that each family could sit at a seperate table and be able to socially distance themselves from others.

Thankfully, I was on the non-COVID inpatient unit this week and our census was manageable. The patients were higher acuity, but not sick enough to be in the ICU. Except for one patient who seemed to heading that way.

I put my phone away and tried to focus on what the intern was presenting about our sickest patient.

"62 year old woman, with a history of diabetes, was bought to the ER earlier this morning by her husband with high fever, and complaint of severe headache. She had no respiratory symptoms. COVID test is negative., and her blood sugars are only mildly elevated so these symptoms are not due to her underlying diabetes. Since being admitted she also seems to have become more and more disoriented and confused"

"She is maintaining her airway and breathing without difficulty right now, but if her mental status changes anymore she'll need to move to the ICU. I'll give them a heads up about her", I offered. The ICUs were still full of COVID patients and finding a bed for anyone else was a challenge.

The intern went over some of the testing we had done so far, "The head CT scan suggests that there is inflammation of her entire brain. And the brain fluid that we obtained through a spinal tap looked like maybe she has a viral infection"

There are some common viruses that can cause brain infection but are usually associated with cold symptoms or some respiratory symptoms. Even COVID had been associated with this kind of infection. But she didn't have any symptoms other than those affecting her brain. Some toxins and drugs could do that too, but her husband swore that she had never used any illicit drugs.

"Did she travel somewhere?", our attending asked.

That question had popped up in my mind too, because there are some viruses, called arboviruses, that can cause this. But they are transmitted by mosquitoes, and you'd have to go outside to a place where there are mosquitoes to get bit by them.

"This woman has not left her house since March this year according to her husband. She works from home and even gets all her grocery delivered to her apartment. She has an anxiety disorder, so I think she is literally afraid of leaving her house during this pandemic. They live on the 40th floor of a high-rise building and the most she has done in the last 4 months is stepped out on to her balcony", I told my attending.

Then I had a second thought, because as they say in medicine...'never say never'.

"Let's just send a test for the arboviruses anyway. I doubt it would be positive...", I told the intern and the attending agreed since we were at loss for another explanation.

We explained all that to the patient's husband and were moving on to the next patient when my phone buzzed again.

Omar?

It wasn't him, it was my sister whose first message said, 'You're not going to like this but...'

Ugh...I hate it when she does that. Why not just type the whole damn message in one go?

I put my phone to silent and placed it back in my pocket. Omar's flight was already on it's way to Chicago after the layover in Dubai, and as long as I was going to see him today nothing else was going to faze me. Besides, I needed to pay attention on rounds and get all my work done asap so I could make sure that I left on time.

And I am glad I put away my phone, because had I known what Maliha was typing in that message, I would have seriously lost it in the middle of rounds!

When we ended rounds a couple of hours later, my attending who was a woman not too much older than myself asked, "So Madi, what are the honeymoon plans?"

"No plans...unfortunately. I am taking two days off from work, but then Omar has to start back on his cardiology rotation next week. So we'll just be at home...watching Netflix for our honeymoon"

She gave me a sympathetic look as we parted ways, which made me sigh. I would have loved to go somewhere in Europe, or an exotic beach or beautiful mountainous region for a honeymoon. But with everything shut down and/or not safe to travel to, the best we could do is walk along Lake Michigan.

But at least we would be together, I reminded myself. Besides, I could think of a few ways to keep ourselves busy at home that did not involve watching movies.

I felt my cheeks burn at the thoughts that were crossing my mind as I walked alone in the hallway. The image of him on my computer screen after our Nikah was etched in my mind. For a second I thought that our connection was bad and my screen was frozen, but then I noticed his lips part, and the way he slowly wet his lips with his tongue, and the change in his breathing pattern as he got that faraway look in his eyes. And I knew exactly what was going through his mind, when he could barely get the words out of his mouth. That had sent me into a spiral of lust and desire, that I had never felt before, or perhaps never let myself feel before.

Come on Madi...not the time to go down that path

But it was too late. My mind could not stop imaging how his hands would feel on my skin, making every inch of me burn with his heated touch. Or how his mouth would taste, as his lips caressed mine. I may not be the prettiest woman out there, but he made me feel seen and desirable, which made me want him even more.

Thankfully, there was an empty patient room nearby and I was able to splash some cold water on my face, which jolted me out of the lustful state my mind had put my body in.

Oh boy! How am I going to get through the function later tonight, with him being physically right next to me...or sit next to him in a car when I pick him up from the airport

Thankfully (or not), before I could descend into a panic mode, my pager went off.

'Patient with headache and fever has West Nile Virus in her CSF!!!' - the intern had messaged.

Wait...what? The fluid around her brain (CSF-cerebrospinal fluid) has one of the arboviruses transmitted by a mosquito? But how did she come into contact with mosquitoes while in isolation on the 40th floor?

I found the intern in the resident room, Googling 'How high can mosquitoes fly?'

Apparently, not very high. They only typically fly 25 feet or so above the ground. And if our patient truly had not left her apartment in the high rise building, which we both doubted she would have given her severe anxiety about the pandemic, how did a mosquito get to her?

The intern was on Google again, and found the answer.

"Looks like the bottom of the elevator can collect rainwater. And it has been raining here recently", he said to me, before reading off the screen again, "That water then becomes a breeding ground for mosquitoes, and the elevator transports the freaking mosquitoes throughout the building"

By now our attending had also joined us in the residents room, and exclaimed, "Poor woman...what bad luck...she doesn't leave her house for fear of one virus, but destiny delivered a mosquito infected with another virus to her house...in an elevator"

While the rest of the team was marveling at the odds of that happening, all I could think of was how little control us humans have over our destinies. It is in our nature to pretend that we can control our futures, but it is next to impossible to predict what fate has in store for you. The best we can do, is learn to adapt while still pursuing our dreams.

That reminded me, I still hadn't bothered looking at Maliha's text message from this morning. I was ready to deal with, or adapt to, whatever it was that she thought I would not like. Because my dream of marrying the man I loved, had already come true.

'You're not going to like this but...'

'Mama and Papa invited Hasan's entire family to your reception'

'Including...'

'Faraz Bhai'

'Call Mama NOW and tell her you don't want him to come. She won't listen to me'

What the heck? What is wrong with my parents?

I called her immediately, "Maliha, tell him he cannot come to my reception, I disinvite him. Omar is going to be absolutely furious when he finds out!"

"Madi, why are you getting upset now? I texted you a long time ago", she replied, sounding annoyed at me, "Mama already called my mother-in-law and told her to make sure Faraz bhai comes because there shouldn't be any ill will between our families. You should have called Mama yourself this morning when I told you to"

"You have got to be kidding me!"

"Sorry Madi...I tried to help. But maybe Mama is not wrong", Maliha replied thoughtfully, "It has been weird at home. Aunty and Uncle seemed a little subdued on your Nikah as well. Maybe this is a good way for everyone to accept the reality and move on"

Destiny...fate...learn to adjust, I reminded myself.

And I still felt bad that because of me my little sister was having to deal with awkwardness in her own home. So, I decided then that even if Omar objects, inviting Faraz to our wedding reception is probably the best way to bury the hatchet once and for all. Besides, Omar and I were already married. Our fate was already sealed. No one could undo that.

Hopefully, Faraz will decide to not come at all!

It was already noon by the time I got off the phone with Maliha. I needed to leave in a little over three hours if I was going to be at the airport on time to pick up Omar. And I had a whole lot of stuff to do for the patients on our current service, as well as catch up on some of my chief resident duties. And I was determined to get through them all so no one would bother me the next two days. I made a page-long list of things-to-do, grabbed coffee and sat down at a workstation.

Three hours later, I was feeling very proud of myself for having completed almost every task on my list, while answering the questions my intern had, and making sure that all our patients had their medications/lab tests ordered. But that feeling of accomplishment was short-lived.

"Dr Ahmed...", a panicked nurse called out to me as I walked past the room of our patient with West Nile Virus brain infection, "Mrs Smith is not waking up at all"

I immediately walked in and after making sure that she was still breathing and had a normal heart rhythm, I asked the nurse to call the rapid response team. That is the ICU team that is called when we need a quick evaluation of a patient to assess whether or not a patient needs to go to the ICU.

"I already ordered a STAT head CT to make sure she isn't having a stroke or something, but I think she should be moved to the ICU. We know she has a viral infection in her brain, and given her age and diabetes, she is at higher risk for more severe infection. She will need to be monitored a lot more closely than we are capable of doing out here on the floor", I tried to advocate for my patient.

The ICU fellow agreed, "I agree Madi, the ICU is full, but if you could accompany the patient down to the CT scanner, I'll go back and see if I can move some patients around"

It was already 3:30 pm. I should have left 15 minutes ago, if I was going to be on-time to pick up Omar. But in that moment, my patient needed me more than Omar did. So I nodded, and rushed out of the room with the rest of the nurses who were accompanying the patient.

I did text Omar to let him know, and he replied immediately.

'Take your time. I am not going anywhere. Go save lives!'

I smiled at his perfect reply, and then put the phone away, turning my attention back to the portable monitors on my patient's bed as she was being prepped for the rapid head CT.

Almost an hour and a half later, I had handed off her care to the ICU team, signed out my patients to the overnight resident, fought the early evening traffic on Chicago highways, parked in the garage opposite the international terminal at O'Hare airport and was standing on the sidewalk scanning all the passengers pouring out of the exit doors across the road.

Then I saw him. Standing there in his black jeans and a light grey polo shirt, his messy mop of hair begging me to run my fingers through it. His scruffy jaw dropped open just a bit as his gaze locked onto me, unwavering and intense, making me forget that I was standing at the arrival terminal of one of the busiest airports in the world. In that moment, there was no one else there, it was just him and I...husband and wife, two souls destined to be together...just separated now by a single lane, one way street and a pedestrian walk light that was still red.

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